Anatomy of Knee Arthritis - Consequences for the Planning of TKAs

作者：Schnurr C^*; Eysel P; Fuerderer S; Koenig D P

来源：Zeitschrift fur Orthopadie und Unfallchirurgie, 2011, 149(6): 653-658.

DOI：10.1055/s-0031-1280308

• anatomy
• knee arthritis, deformities
• knee replacement
• bone resections

Background: Principles in total knee arthroplasty include a reconstructed mechanical axis and minimal bone loss. So far no study has analysed the anatomy of knee arthritis and its consequences for the implant planning. Therefore it has been the aim of our study to analyse typical deformities of arthritic knees and their consequences for the implant planning. Material and
Methods: The data of 712 navigated total knee arthroplasties have been analysed. The deformities of the tibia and femur were measured. Algorithms have been developed to calculate the optimal tibial and femoral resection depths.
Results: The deformity in varus arthritis must be corrected on the tibial side, in valgus arthritis on the femoral side. The optimal tibial resection depth in varus arthritis corresponds to the thinnest insert; in valgus arthritis 3 mm less is adequate. The femoral resection depth in varus arthritis corresponds to the implant thickness; in valgus arthritis a 1 mm deeper resection is mostly required.
Conclusions: Varus and valgus deformities significantly differ in location of the deformity and required resection depth. A knowledge of these typical deformities enables an intraoperative control of the axis correction. A reduced tibial resection depth in valgus deformities saves bone stock for revision surgery and avoids larger insert sizes.

• 出版日期2011-12